Psychiatric Times reports that "His Holiness" participated in a conference on depression:
The conference focused on the role that meditation might play in promoting cognitive, emotional, and physiological states that are protective against depression. This issue was examined within the broader context of whether developing mindfulness and greater compassion through meditation training in adulthood might help individuals compensate for the depressogenic effects of adversity, trauma, and lack of nurturance early in life, all of which are primary environmental contributors to major depression.
During the conference, researchers presented data that suggested that mindfulness practices may help prevent the recurrence of major depression and that meditation practices specifically designed to promote compassionate cognitions and emotions toward others may have effects on the brain and body that are directly relevant to depression.
The Dalai Lama opened the conference by acknowledging the unique relationship that exists between Emory University and several leading institutions of higher education within the Tibetan exile community, a relationship that has culminated in the Dalai Lama joining the Emory faculty as a Distinguished Presidential Professor. He expressed his conviction that Western physical sciences and Buddhist traditions of studying the mind have much to offer each other in better understanding mind-body interactions relevant to health.
It's no wonder that other medical specialties look down on psychiatry.
Monday, March 31, 2008
Sunday, March 23, 2008
eHealthTech
The billing for my outpatient sleep practice as well as for Somnus Sleep Clinic (sleep studies) is done by eHealthTech. eHealthTech is stationed in MS, but handles medical billing and physician practice management across the country. I highly recommend eHealthTech to physicians of all specialties.
Saturday, March 01, 2008
The government is watching you
The AP reports:
In coming weeks, private audit companies will begin scouring mountains of medical records. Their mission: Determine if health care providers erred when billing Medicare and require them to return any overpayments to the federal government. The auditors will keep a tidy percentage for their services.The contractors have shown they're pretty good at their work. In just three years, they've returned more than $300 million to the federal government - and that's just from three states. That experiment is winding down. But a larger, national program will soon take its place.The rollout of "recovery audit contractors" will be gradual. They'll monitor health care providers in 19 states beginning this spring. In October, an additional five states will join.
Health care providers are nearly unanimous in their dislike of the program's continuation, much less its expansion. Many lawmakers have similar sentiments, though it was Congress in 2006 that made the program permanent. A bill sponsored by Rep. Lois Capps, D-Calif., calls for a one-year moratorium.The program's critics say that contractors have too much incentive to question as many claims as possible. That's because they get to keep about 20 percent of the overpayments."What we have here is bureaucrats and government contractors coming in and trying to second guess what doctors and nurses have done in a hospital setting," said Don May, vice president for policy at the American Hospital Association. "They're playing Monday morning quarterback."
While the contractors are often described as overzealous, that's a compliment as far as one watchdog group is concerned."A little zealotry is what were looking for on the part of the taxpayers," said Leslie Paige, spokeswoman for Citizens Against Government Waste.
When the program goes national, all contractors must have a medical director on staff. The agency also is limiting how far back auditors can look when reviewing patient records. The limit will be three years, but under no circumstances, before Oct. 1, 2007.Finally, the agency is working on regulations that would defer repayment until after the appeals process is completed. Currently, the money is taken back regardless of the appeal status, which providers say is a financial burden and akin to guilty until proven innocent.But what gets health care providers most upset is when auditors determined a procedure or hospital admission was not medically necessary.May said that there's a "lot of gray area" when it comes to whether a patients needs to be admitted to a hospital or rehab facility. Often the patients have diabetes or other complicating factors that prompt a physician to want closer monitoring."You need a physician looking at these daily if not more so to make sure the patients are being managed effectively," May said.
In coming weeks, private audit companies will begin scouring mountains of medical records. Their mission: Determine if health care providers erred when billing Medicare and require them to return any overpayments to the federal government. The auditors will keep a tidy percentage for their services.The contractors have shown they're pretty good at their work. In just three years, they've returned more than $300 million to the federal government - and that's just from three states. That experiment is winding down. But a larger, national program will soon take its place.The rollout of "recovery audit contractors" will be gradual. They'll monitor health care providers in 19 states beginning this spring. In October, an additional five states will join.
Health care providers are nearly unanimous in their dislike of the program's continuation, much less its expansion. Many lawmakers have similar sentiments, though it was Congress in 2006 that made the program permanent. A bill sponsored by Rep. Lois Capps, D-Calif., calls for a one-year moratorium.The program's critics say that contractors have too much incentive to question as many claims as possible. That's because they get to keep about 20 percent of the overpayments."What we have here is bureaucrats and government contractors coming in and trying to second guess what doctors and nurses have done in a hospital setting," said Don May, vice president for policy at the American Hospital Association. "They're playing Monday morning quarterback."
While the contractors are often described as overzealous, that's a compliment as far as one watchdog group is concerned."A little zealotry is what were looking for on the part of the taxpayers," said Leslie Paige, spokeswoman for Citizens Against Government Waste.
When the program goes national, all contractors must have a medical director on staff. The agency also is limiting how far back auditors can look when reviewing patient records. The limit will be three years, but under no circumstances, before Oct. 1, 2007.Finally, the agency is working on regulations that would defer repayment until after the appeals process is completed. Currently, the money is taken back regardless of the appeal status, which providers say is a financial burden and akin to guilty until proven innocent.But what gets health care providers most upset is when auditors determined a procedure or hospital admission was not medically necessary.May said that there's a "lot of gray area" when it comes to whether a patients needs to be admitted to a hospital or rehab facility. Often the patients have diabetes or other complicating factors that prompt a physician to want closer monitoring."You need a physician looking at these daily if not more so to make sure the patients are being managed effectively," May said.
Tuesday, February 19, 2008
Primary Care is Growing (sort of)
The American College of Physicians reports that fewer American physicians are entering primary care specialties. However, the overall number of primary care providers is increasing due to nurse practitioners, physician assistants, and IMG's:
Although fewer Americans become primary care physicians, primary care providers increased per capita thanks to international medical graduates and the growth in physician assistants and nurse practitioners. And the overall growth in primary care provided more efficient and less expensive health care, according to testimony given to Congress last week.
The Government Accountability Office (GAO), Congress' research arm, provided testimony to the Senate Health, Education, Labor and Pensions Committee. In the past decade, the per capita number of primary care doctors, including internists, pediatricians, family practitioners and general practitioners, rose an average of 1.17% annually.
The per capita number of primary care physicians grew faster than that of specialty physicians, 12% vs. 5%, respectively. The Associated Press reported from the GAO's testimony that fewer American medical graduates choose primary care, but international medical graduates (IMGs) covered the gap. GAO figures show that in 2006 there were 22,146 American doctors in residency programs in the U.S. specializing in primary care, down from 23,801 the previous year. IMGs made up 1 in 4 new U.S. physicians, according to the AP.
Although fewer Americans become primary care physicians, primary care providers increased per capita thanks to international medical graduates and the growth in physician assistants and nurse practitioners. And the overall growth in primary care provided more efficient and less expensive health care, according to testimony given to Congress last week.
The Government Accountability Office (GAO), Congress' research arm, provided testimony to the Senate Health, Education, Labor and Pensions Committee. In the past decade, the per capita number of primary care doctors, including internists, pediatricians, family practitioners and general practitioners, rose an average of 1.17% annually.
The per capita number of primary care physicians grew faster than that of specialty physicians, 12% vs. 5%, respectively. The Associated Press reported from the GAO's testimony that fewer American medical graduates choose primary care, but international medical graduates (IMGs) covered the gap. GAO figures show that in 2006 there were 22,146 American doctors in residency programs in the U.S. specializing in primary care, down from 23,801 the previous year. IMGs made up 1 in 4 new U.S. physicians, according to the AP.
Monday, January 21, 2008
Robert E Lee/MLK day
LITTLE ROCK, Ark. (AP) -- While the nation honors the Rev. Martin Luther King Jr. on Monday, three states celebrate another man as well. In Arkansas, Alabama and Mississippi, the slain civil rights leader shares a state holiday with Robert E. Lee, commanding officer of the Confederate Army.
Here's Huckabee's position on the holiday:
In 1997, a spokesman for then-Gov. Mike Huckabee said that both men should be honored. Huckabee, currently running for thr Republican presidential nomination, in 1999 signed the bill that gave the Legislature a holiday on King Day
Here's Huckabee's position on the holiday:
In 1997, a spokesman for then-Gov. Mike Huckabee said that both men should be honored. Huckabee, currently running for thr Republican presidential nomination, in 1999 signed the bill that gave the Legislature a holiday on King Day
Saturday, January 12, 2008
Thursday, January 03, 2008
Fallling Knives
Slate has a nice article today about the dangers and rewards of trying to catch a falling knife:
One of the nice things about being a billionaire, or a private-equity magnate, or the CEO of a gigantic bank is that you don't fret about paying retail. If you see an object you desire—a plane, a mansion, a car, a suit—you don't wait for it to go on sale. You just buy it.
In their professional lives, however, such players are attracted to marked-down merchandise like post-Christmas shoppers are drawn to Macy's. Picking through the discard bin and sifting through marked-down inventory of formerly hot products is a highly respected investment strategy. But efforts to catch such falling knives depend on perfect timing. Stick your hand out too late, and you get nothing. Grab the handle at precisely the right moment, and you've got yourself a set of Wüsthofs on the cheap. Stick your hand out too early, and you're simply impeding the blade's fall to earth. Today, several savvy financial operators who tried to catch falling knives in the formerly hot housing and credit sectors are walking around with huge gashes in their hands.
On Aug. 22, Bank of America decided things couldn't get worse for Countrywide Financial, the massive mortgage firm whose stock had been halved since the beginning of the year. Bank of America boldly announced a $2 billion investment in the form of a security that pays a 7.25 percent annual interest payment and "can be converted into common stock at $18 per share." In the months since then, Countrywide, stung by a deteriorating housing market, has fallen another 50 percent. Today, its stock trades at about $9. Bank of America, which is already licking its wounds from an ill-timed plunge into investment banking, is already out several hundred million dollars on its investment in Countrywide.
In the fall, Bear Stearns, the mortgage-dependent Wall Street firm that soared to dizzying heights as the credit market boomed only to crash back to earth, attracted an international cast of falling-knife catchers. In September, Joseph Lewis, one of Britain's wealthiest men, spent $860 million on a 7 percent stake in Bear, paying an average of about $107 per share, according to the Wall Street Journal. In December, he boosted his stake twice. Today, with Bear's stock trading at close to $85, Lewis has turned his massive fortune into something slightly smaller. He's likely lost about 15 percent of his investment. In October, Bear agreed to a complicated deal with CITIC Securities, in which the Chinese firm would invest $1 billion in Bear Stearns for a stake worth at least 6 percent. Since then, Bear's stock has fallen about 20 percent.
Some investors have suffered deeper wounds. On Dec. 10, Warburg Pincus—a very sharp private-equity firm—agreed to invest up to $1 billion in struggling bond insurer MBIA, which had lost 55 percent of its value in the previous two months. Warburg bought 16.1 million shares at $31 a share and committed to fund another $500 million. (The deal also included warrants to buy several million shares of the company's stock at $40 per share.) Within days, as MBIA dealt with questions about its exposure to collateralized debt obligations and other exotica, the company's stock plummeted to $19. In less than two weeks, Warburg lost nearly 30 percent on its investment in the shares, or about $183 million. And that was before deep-pocketed investor Warren Buffett said he might start his own bond insurer to compete with MBIA.
Of course, it's early days, and these investments could well turn out to be genius moves. But the experience of these knife-catchers highlights a significant difference between the denouement of the dot-com bubble and the real-estate/credit bubble. In the former, the end came swiftly and violently. Since the bubble activity was concentrated in highly liquid, publicly traded stocks, investors—mutual funds, hedge funds, individuals—were all able to flee at the same time. The NASDAQ Composite—the epicenter of the bubble—fell 37 percent in two months in the spring of 2000, and nearly 75 percent between late March 2000 and April 2001. In some instances, this herdlike behavior created overreactions that set the stage for smart Dumpster-diving investors. In April 2003, Apple's stock traded for a split-adjusted $6.60; today it's at $198.
This time around, the bubble activity was concentrated in comparatively illiquid assets—like mortgage-backed securities, collateralized debt obligations, and houses. It may seem obvious now, but homes don't trade with the same speed and lack of friction that stocks do. And when housing prices fall, builders don't respond by slashing prices with alacrity; they respond by keeping prices the same and throwing in amenities, or, as the Wall Street Journal reported, by funneling cash back to buyers through third parties. The housing bubble popped, but between October 2006 and October 2007, according to the Case-Shiller index, housing prices fell only 6.1 percent. Housing prices may need to fall 30 percent or 40 percent before they bottom out, but it will take years—rather than months—for that process to play out. And as the market continues to slump, companies whose business models rest on making mortgages—and on buying, selling, and insuring securities based on mortgages—may face a string of losses.
Not all knife-catchers have been hurt, though. Goldman Sachs was one of the few Wall Street firms to prosper during the subprime tsunami, as it used its own cash to make bearish bets on subprime securities. By late December, First Marblehead, the student-loan company, had lost about 75 percent of its value over the course of 2007, as investors fretted over loan defaults and rising financing costs. On Dec. 21, Goldman's private-equity unit stepped in and agreed to buy up to 20 percent of the company for $260.5 million and offer a line of credit. With First Marblehead's stock having rallied from $11 to about $15 today, Goldman is solidly in the money on its investment. Many analysts already believe the sharp traders and risk analysts at Goldman have superhuman powers. Its ability to overcome the force of gravity and halt a plummeting financial-services stock may only add to the firm's legend.
One of the nice things about being a billionaire, or a private-equity magnate, or the CEO of a gigantic bank is that you don't fret about paying retail. If you see an object you desire—a plane, a mansion, a car, a suit—you don't wait for it to go on sale. You just buy it.
In their professional lives, however, such players are attracted to marked-down merchandise like post-Christmas shoppers are drawn to Macy's. Picking through the discard bin and sifting through marked-down inventory of formerly hot products is a highly respected investment strategy. But efforts to catch such falling knives depend on perfect timing. Stick your hand out too late, and you get nothing. Grab the handle at precisely the right moment, and you've got yourself a set of Wüsthofs on the cheap. Stick your hand out too early, and you're simply impeding the blade's fall to earth. Today, several savvy financial operators who tried to catch falling knives in the formerly hot housing and credit sectors are walking around with huge gashes in their hands.
On Aug. 22, Bank of America decided things couldn't get worse for Countrywide Financial, the massive mortgage firm whose stock had been halved since the beginning of the year. Bank of America boldly announced a $2 billion investment in the form of a security that pays a 7.25 percent annual interest payment and "can be converted into common stock at $18 per share." In the months since then, Countrywide, stung by a deteriorating housing market, has fallen another 50 percent. Today, its stock trades at about $9. Bank of America, which is already licking its wounds from an ill-timed plunge into investment banking, is already out several hundred million dollars on its investment in Countrywide.
In the fall, Bear Stearns, the mortgage-dependent Wall Street firm that soared to dizzying heights as the credit market boomed only to crash back to earth, attracted an international cast of falling-knife catchers. In September, Joseph Lewis, one of Britain's wealthiest men, spent $860 million on a 7 percent stake in Bear, paying an average of about $107 per share, according to the Wall Street Journal. In December, he boosted his stake twice. Today, with Bear's stock trading at close to $85, Lewis has turned his massive fortune into something slightly smaller. He's likely lost about 15 percent of his investment. In October, Bear agreed to a complicated deal with CITIC Securities, in which the Chinese firm would invest $1 billion in Bear Stearns for a stake worth at least 6 percent. Since then, Bear's stock has fallen about 20 percent.
Some investors have suffered deeper wounds. On Dec. 10, Warburg Pincus—a very sharp private-equity firm—agreed to invest up to $1 billion in struggling bond insurer MBIA, which had lost 55 percent of its value in the previous two months. Warburg bought 16.1 million shares at $31 a share and committed to fund another $500 million. (The deal also included warrants to buy several million shares of the company's stock at $40 per share.) Within days, as MBIA dealt with questions about its exposure to collateralized debt obligations and other exotica, the company's stock plummeted to $19. In less than two weeks, Warburg lost nearly 30 percent on its investment in the shares, or about $183 million. And that was before deep-pocketed investor Warren Buffett said he might start his own bond insurer to compete with MBIA.
Of course, it's early days, and these investments could well turn out to be genius moves. But the experience of these knife-catchers highlights a significant difference between the denouement of the dot-com bubble and the real-estate/credit bubble. In the former, the end came swiftly and violently. Since the bubble activity was concentrated in highly liquid, publicly traded stocks, investors—mutual funds, hedge funds, individuals—were all able to flee at the same time. The NASDAQ Composite—the epicenter of the bubble—fell 37 percent in two months in the spring of 2000, and nearly 75 percent between late March 2000 and April 2001. In some instances, this herdlike behavior created overreactions that set the stage for smart Dumpster-diving investors. In April 2003, Apple's stock traded for a split-adjusted $6.60; today it's at $198.
This time around, the bubble activity was concentrated in comparatively illiquid assets—like mortgage-backed securities, collateralized debt obligations, and houses. It may seem obvious now, but homes don't trade with the same speed and lack of friction that stocks do. And when housing prices fall, builders don't respond by slashing prices with alacrity; they respond by keeping prices the same and throwing in amenities, or, as the Wall Street Journal reported, by funneling cash back to buyers through third parties. The housing bubble popped, but between October 2006 and October 2007, according to the Case-Shiller index, housing prices fell only 6.1 percent. Housing prices may need to fall 30 percent or 40 percent before they bottom out, but it will take years—rather than months—for that process to play out. And as the market continues to slump, companies whose business models rest on making mortgages—and on buying, selling, and insuring securities based on mortgages—may face a string of losses.
Not all knife-catchers have been hurt, though. Goldman Sachs was one of the few Wall Street firms to prosper during the subprime tsunami, as it used its own cash to make bearish bets on subprime securities. By late December, First Marblehead, the student-loan company, had lost about 75 percent of its value over the course of 2007, as investors fretted over loan defaults and rising financing costs. On Dec. 21, Goldman's private-equity unit stepped in and agreed to buy up to 20 percent of the company for $260.5 million and offer a line of credit. With First Marblehead's stock having rallied from $11 to about $15 today, Goldman is solidly in the money on its investment. Many analysts already believe the sharp traders and risk analysts at Goldman have superhuman powers. Its ability to overcome the force of gravity and halt a plummeting financial-services stock may only add to the firm's legend.
Monday, December 31, 2007
Saturday, December 22, 2007
Anticonvulsants for Alcoholism
Several studies studies support the use of the anticonvulsant Topiramate (Topamax) for alcohol dependence.
A new study supports the use of Gabapentin (Neurontin) in the early post-withdrawal period:
NEW YORK (Reuters Health) Dec 17 - The anticonvulsant gabapentin reduces alcohol consumption and craving during treatment for alcohol dependence, Brazilian researchers report in the Journal of Clinical Psychiatry for November.
Dr. Fernando A. Furieri, at the Vitoria Municipal Addiction Treatment Center, and Dr. Ester M. Nakamura-Palacios, at the Federal University of Espirito Santo in Vitoria, conducted a randomized, double-blind trial involving 60 subjects, whose average consumption exceeded 35 drinks per week.
After a 7-day treatment for acute withdrawal, subjects were randomly assigned to gabapentin up to 600 mg/day, or placebo for 28 days. Thirty-nine patients had used diazepam during the acute phase; 15 in the placebo group and 13 in the gabapentin continued to do so during the trial phase.
The number of drinks per day, per week, and over the 4-week course of treatment had declined significantly more in the gabapentin group than in the placebo group. Gabapentin was also associated with fewer heavy drinking days and more days of abstinence. The authors note that 20 subjects in the gabapentin group and 13 in the placebo group maintained complete abstinence.
According to scores on the Obsessive Compulsive Drinking Scale, craving for alcohol was also reduced significantly more by gabapentin.
"Gabapentin has shown great potential in the treatment of alcohol dependence and withdrawal syndromes," either as monotherapy or as an add-on pharmacotherapy, the authors conclude.
J Clin Psychiatry 2007;68:1691-1700.
Non-anticonvulsants useful for the treatment of alcohol dependence include antabuse, naltrexone, and acamprosate.
A new study supports the use of Gabapentin (Neurontin) in the early post-withdrawal period:
NEW YORK (Reuters Health) Dec 17 - The anticonvulsant gabapentin reduces alcohol consumption and craving during treatment for alcohol dependence, Brazilian researchers report in the Journal of Clinical Psychiatry for November.
Dr. Fernando A. Furieri, at the Vitoria Municipal Addiction Treatment Center, and Dr. Ester M. Nakamura-Palacios, at the Federal University of Espirito Santo in Vitoria, conducted a randomized, double-blind trial involving 60 subjects, whose average consumption exceeded 35 drinks per week.
After a 7-day treatment for acute withdrawal, subjects were randomly assigned to gabapentin up to 600 mg/day, or placebo for 28 days. Thirty-nine patients had used diazepam during the acute phase; 15 in the placebo group and 13 in the gabapentin continued to do so during the trial phase.
The number of drinks per day, per week, and over the 4-week course of treatment had declined significantly more in the gabapentin group than in the placebo group. Gabapentin was also associated with fewer heavy drinking days and more days of abstinence. The authors note that 20 subjects in the gabapentin group and 13 in the placebo group maintained complete abstinence.
According to scores on the Obsessive Compulsive Drinking Scale, craving for alcohol was also reduced significantly more by gabapentin.
"Gabapentin has shown great potential in the treatment of alcohol dependence and withdrawal syndromes," either as monotherapy or as an add-on pharmacotherapy, the authors conclude.
J Clin Psychiatry 2007;68:1691-1700.
Non-anticonvulsants useful for the treatment of alcohol dependence include antabuse, naltrexone, and acamprosate.
Saturday, December 08, 2007
Different duty of care for psychiatrists and internists
A member of iMedExchange posted about this article:
A general practitioner who slept with a patient's wife -- who was also a patient -- can't be sued for malpractice in Pennsylvania, a three-judge panel concluded, affirming a decision issued by the Philadelphia Court of Common Pleas last year in Long v. Ostroff. Sexual misconduct "may be unethical," the court noted, but state law doesn't recognize such a claim for professional negligence because a general practitioner's duty of care doesn't prohibit that behavior. Unlike psychiatrists, who have a "special duty" to refrain from engaging in sexual relations with a patient's spouse, general practitioners don't have such a duty, Senior Judge Justin M. Johnson explained.
I wonder which standard would apply to me. I am boarded in Internal Medicine and Psychiatry. I primarily practice sleep medicine, which is a subspecialty of both internal medicine and psychiatry. Most insurance plans don't recognize sleep medicine as a specialty, and some list me as internal medicine and some as psychiatry. I took the old sleep boards as well as the new sleep boards (results pending) as an internist. As much as the legal process fascinates me, I guess I better not try to become the subject of a Supreme Court case.
A general practitioner who slept with a patient's wife -- who was also a patient -- can't be sued for malpractice in Pennsylvania, a three-judge panel concluded, affirming a decision issued by the Philadelphia Court of Common Pleas last year in Long v. Ostroff. Sexual misconduct "may be unethical," the court noted, but state law doesn't recognize such a claim for professional negligence because a general practitioner's duty of care doesn't prohibit that behavior. Unlike psychiatrists, who have a "special duty" to refrain from engaging in sexual relations with a patient's spouse, general practitioners don't have such a duty, Senior Judge Justin M. Johnson explained.
I wonder which standard would apply to me. I am boarded in Internal Medicine and Psychiatry. I primarily practice sleep medicine, which is a subspecialty of both internal medicine and psychiatry. Most insurance plans don't recognize sleep medicine as a specialty, and some list me as internal medicine and some as psychiatry. I took the old sleep boards as well as the new sleep boards (results pending) as an internist. As much as the legal process fascinates me, I guess I better not try to become the subject of a Supreme Court case.
Wednesday, December 05, 2007
R.I.P.
LAS VEGAS (AP) -- David "Chip" Reese, a card star who won one of the biggest cash games in the world and three World Series of Poker championships, has died. He was 56.
Reese died in his sleep and was found by his son early Tuesday morning at his Las Vegas home after suffering from symptoms of pneumonia, said poker great Doyle Brunson, his longtime friend.
Despite winning three World Series champion's bracelets over the last four decades, including a $1.8 million HORSE event in 2005 that combines five poker disciplines, Reese focused his attention on high-stakes cash games away from the limelight.
"I've seen him with a million dollars in front of him," said Dalla, describing how Reese would put out racks of $5,000 chips "like he was betting a few bucks."
Reese was part of a generation of players in the 1970s that challenged established greats like Brunson, Thomas "Amarillo Slim" Preston Jr. and Walter Clyde "Puggy" Pearson, Dalla said.
Reese died in his sleep and was found by his son early Tuesday morning at his Las Vegas home after suffering from symptoms of pneumonia, said poker great Doyle Brunson, his longtime friend.
Despite winning three World Series champion's bracelets over the last four decades, including a $1.8 million HORSE event in 2005 that combines five poker disciplines, Reese focused his attention on high-stakes cash games away from the limelight.
"I've seen him with a million dollars in front of him," said Dalla, describing how Reese would put out racks of $5,000 chips "like he was betting a few bucks."
Reese was part of a generation of players in the 1970s that challenged established greats like Brunson, Thomas "Amarillo Slim" Preston Jr. and Walter Clyde "Puggy" Pearson, Dalla said.
Thursday, November 22, 2007
Chantix Linked to Suicide
The U.S. Food and Drug Administration is looking into reports that the anti-smoking drug Chantix may trigger mood swings and thoughts of suicide in patients taking it.
Information provided to the agency by Chantix manufacturer, Pfizer Inc. cited "erratic behavior" in an individual who had used Chantix. The agency is also investigating the death of the person who used the drug, but was also under the influence of alcohol.
The FDA has asked Pfizer for any additional information it has on reports of adverse reactions in people taking the drug. Its Center for Drug Evaluation and Research is analyzing the data and plans to release its findings to the public once the analysis is completed.
In the meantime, the agency recommends that health care providers monitor patients taking Chantix. Patients taking Chantix should contact their doctors if they experience behavior or mood changes, the FDA said.
The FDA also advises that patients taking Chantix use caution when driving or operating machinery due to reports of drowsiness.
From Foxnews
Ultimately, I don't think this is going to pan out. I don't think that Chantix causes suicide. However, in the short term I forsee further declines in Pfizer's stock price. Currently, it's just above its 52 week low. I think Pfizer will be a good buy at around 20, and recommend waiting until then to buy Pfizer.
Information provided to the agency by Chantix manufacturer, Pfizer Inc. cited "erratic behavior" in an individual who had used Chantix. The agency is also investigating the death of the person who used the drug, but was also under the influence of alcohol.
The FDA has asked Pfizer for any additional information it has on reports of adverse reactions in people taking the drug. Its Center for Drug Evaluation and Research is analyzing the data and plans to release its findings to the public once the analysis is completed.
In the meantime, the agency recommends that health care providers monitor patients taking Chantix. Patients taking Chantix should contact their doctors if they experience behavior or mood changes, the FDA said.
The FDA also advises that patients taking Chantix use caution when driving or operating machinery due to reports of drowsiness.
From Foxnews
Ultimately, I don't think this is going to pan out. I don't think that Chantix causes suicide. However, in the short term I forsee further declines in Pfizer's stock price. Currently, it's just above its 52 week low. I think Pfizer will be a good buy at around 20, and recommend waiting until then to buy Pfizer.
Saturday, November 17, 2007
Doctors in Debt
Cnn.com Business Section presents a case study of 2 residents deeply in debt:
It's all supposed to pay off, of course. Once they become full-fledged doctors (attending physicians, in the trade), they'll have six-figure incomes, more reasonable hours, a respected occupation and work that they love.
But for this generation of doctors, and for Meg and Chris in particular, financial security won't come guaranteed with their medical licenses. As health-care economics squeeze physician salaries, rising college and med school tuitions are putting young doctors ever deeper in the hole.
Chris and Meg live frugally, work hard and are making the kind of investments in their future that would make any parent proud. But they're also on track to finish their medical training in the next few years with a staggering $700,000 in debt.
It's all supposed to pay off, of course. Once they become full-fledged doctors (attending physicians, in the trade), they'll have six-figure incomes, more reasonable hours, a respected occupation and work that they love.
But for this generation of doctors, and for Meg and Chris in particular, financial security won't come guaranteed with their medical licenses. As health-care economics squeeze physician salaries, rising college and med school tuitions are putting young doctors ever deeper in the hole.
Chris and Meg live frugally, work hard and are making the kind of investments in their future that would make any parent proud. But they're also on track to finish their medical training in the next few years with a staggering $700,000 in debt.
Tuesday, November 13, 2007
Drug Company Lunches
I once sneezed all over a fresh pan of Olive Garden lasagna multiple times. The big, fat office hogs never noticed. They sucked it down like there was no tomorrow.
Read this site before you eat any more drug company lunches.
( via Kevin MD)
Read this site before you eat any more drug company lunches.
( via Kevin MD)
Monday, November 12, 2007
Getting Spanked
More banks brace for subprime spanking
I saw this headline in the green section of USAToday this morning.
Rather unprofessional language for a major newspaper. Within a few years we'll probably be reading about the Dow being "bitch-slapped" in the pages of USAToday ("bitch-slapped" is probably a good term to describe today's 55 point drop).
I saw this headline in the green section of USAToday this morning.
Rather unprofessional language for a major newspaper. Within a few years we'll probably be reading about the Dow being "bitch-slapped" in the pages of USAToday ("bitch-slapped" is probably a good term to describe today's 55 point drop).
Thursday, November 08, 2007
The death of sleep medicine
Please see my post on sleepdoctor about portable testing for obstructive sleep apnea.
I wish to thank Kevin, M.D. for linking to it.
I wish to thank Kevin, M.D. for linking to it.
Saturday, November 03, 2007
Mississippi's Governor
Mississippi's Governor, Haley Barbour, has been ranked as one of the country's most influential conservatives:
About to be comfortably re-elected as Mississippi governor, Barbour is one of the most accomplished Republican executives in the United States. As a successful Southern governor with immense experience, he is a potential future presidential candidate who would be a clever pick for vice-presidential running mate in 2008. Received national plaudits for his handling of the aftermath of Hurricane Katrina, which devastated Mississippi's Gulf coast, while neighbouring Louisiana's Democratic governor floundered.Barbour, 60, has cut his state's budget deficit in half without raising taxes and used the skills he honed as a Washington lobbyist to good effect in winning over a Democratic-led state legislature. A highly successful chair of the Republican National Committee, Barbour helped lay the foundations for the Republican Revolution and the takeover of Congress in 1994.
(via Drudge)
About to be comfortably re-elected as Mississippi governor, Barbour is one of the most accomplished Republican executives in the United States. As a successful Southern governor with immense experience, he is a potential future presidential candidate who would be a clever pick for vice-presidential running mate in 2008. Received national plaudits for his handling of the aftermath of Hurricane Katrina, which devastated Mississippi's Gulf coast, while neighbouring Louisiana's Democratic governor floundered.Barbour, 60, has cut his state's budget deficit in half without raising taxes and used the skills he honed as a Washington lobbyist to good effect in winning over a Democratic-led state legislature. A highly successful chair of the Republican National Committee, Barbour helped lay the foundations for the Republican Revolution and the takeover of Congress in 1994.
(via Drudge)
Wednesday, October 31, 2007
Atheism
They say that there are no atheists in foxholes. Being unable to sell one's house can also turn a person away from atheism:
The Catholic saint has long been believed to help with home-related matters. And according to lore now spreading on the Internet and among desperate home-sellers, burying St. Joseph in the yard of a home for sale promises a prompt bid.
With the worst housing market in recent years, St. Joseph is enjoying a flurry of attention. Some vendors of religious supplies say St. Joseph statues are flying off the shelves as an increasing number of skeptics and non-Catholics look for some saintly intervention to help them sell their houses.
Some Realtors, too, swear by the practice. Ardell DellaLoggia, a Seattle-area Realtor, buried a statue beneath the "For Sale" sign on a property that she thought was overpriced. She didn't tell the owner until after it had sold. "He was an atheist," she explains. "But he thanked me."
Catholic leaders also say that faith and devotion are necessary, in addition to burying a statue, otherwise the practice amounts to little more than superstition or magic. But they are also enjoying the saint's newfound popularity. "If they have a good result and they think it was St. Joseph, it might inspire them to practice more," says Msgr. Connell.
The Catholic saint has long been believed to help with home-related matters. And according to lore now spreading on the Internet and among desperate home-sellers, burying St. Joseph in the yard of a home for sale promises a prompt bid.
With the worst housing market in recent years, St. Joseph is enjoying a flurry of attention. Some vendors of religious supplies say St. Joseph statues are flying off the shelves as an increasing number of skeptics and non-Catholics look for some saintly intervention to help them sell their houses.
Some Realtors, too, swear by the practice. Ardell DellaLoggia, a Seattle-area Realtor, buried a statue beneath the "For Sale" sign on a property that she thought was overpriced. She didn't tell the owner until after it had sold. "He was an atheist," she explains. "But he thanked me."
Catholic leaders also say that faith and devotion are necessary, in addition to burying a statue, otherwise the practice amounts to little more than superstition or magic. But they are also enjoying the saint's newfound popularity. "If they have a good result and they think it was St. Joseph, it might inspire them to practice more," says Msgr. Connell.
Tuesday, October 30, 2007
Mediocre Care for the Poor Elderly
Vulnerable elderly receive mediocre health care, study finds
The quality of care for vulnerable elderly people on Medicaid and Medicare is “mediocre,” the authors of a new study concluded.
Researchers did a cohort study of 100,528 dual Medicaid/Medicare enrollees from 19 California counties who were age 75 and older in 1999 and 2000. They measured the care provided for 44 quality indicators (QIs) by condition, like heart failure, and intervention, such as medication, using QIs developed by the Assessing Care of Vulnerable Elders project. The article was published in the October Medical Care.
This study, as summarized by the American College of Physicians, found "medicore" care for elderly dual Medicare/Medicaid enrollees. This is the sickest, toughest population to treat. Reimbursement is less than mediocre, though that's no excuse.
The quality of care for vulnerable elderly people on Medicaid and Medicare is “mediocre,” the authors of a new study concluded.
Researchers did a cohort study of 100,528 dual Medicaid/Medicare enrollees from 19 California counties who were age 75 and older in 1999 and 2000. They measured the care provided for 44 quality indicators (QIs) by condition, like heart failure, and intervention, such as medication, using QIs developed by the Assessing Care of Vulnerable Elders project. The article was published in the October Medical Care.
This study, as summarized by the American College of Physicians, found "medicore" care for elderly dual Medicare/Medicaid enrollees. This is the sickest, toughest population to treat. Reimbursement is less than mediocre, though that's no excuse.
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